For this feature, we interviewed Dave Johnson, Director of Member Relations and Business Development with Rural Wisconsin Hospital Cooperative (RWHC). RWHC is a NCHN Network Member and Member Business Partner and is well-established as a strong, successful network. Dave Johnson is currently serving his second year on the NCHN Board of Directors and has participated on numerous committees. He is an active member and a great resource. Read on for information from Dave about RWHC's work and methods, as well as the importance of member engagement, network adaptation, and other valuable network initiatives.

Q: RWHC has a powerful vision: “Rural Wisconsin communities will be the healthiest in America.” There has been a strong emphasis on evidence-based outcomes recently. When RWHC plans for the vision, what is your starting point for that and what general baselines and outcomes are you using to measure it?

DJ: The co-op has had a long standing commitment to working with and through our member hospitals to improve the health of their respective communities.  This commitment has been evidenced by several grant projects that focus on improving services (clinical outcomes, patient safety, and patient satisfaction) delivered to people across the State.  Often times, these grants will develop into a new shared service line for RWHC, and those services help to sustain the work of the co-op, so that we can continue to serve our members in their work improving population health.  As we continue to try and move the needle forward on the triple aim of healthcare in Wisconsin (better health, better care, and lower costs) much of the work of the co-op is currently focused on quality, and improving outcomes for our members and their patients.  Population health continues to become more of a buzzword around Wisconsin, and is becoming more prevalent as we look for future service development.  Efficiency and cost reduction have always played an integral role in the mission of this organization, and that is only becoming more and more important as we move forward in the new and ever changing healthcare landscape. 

Q: What are some of the tangible outcomes of RWHC’s work?

DJ: At the simplest level, our charge is twofold; advocate for rural healthcare, and develop and deliver high quality shared services, at an affordable price.  The co-op has been very fortunate to have many outstanding member hospitals that are committed to the organization and support the mission, values, and vision.   That commitment has helped us to develop a myriad of deliverables to our members, as well as non-member clients.  Some examples include; education (clinical & managerial), quality indicators reporting, patient satisfaction surveys, financial consulting and benchmarking services, a shared EHR platform and staffing support, PACS, shared clinical staffing, and numerous joint projects with our members and other strategic partnerships, including the Wisconsin Hospital Association, the Wisconsin Office of Rural Health, and the National Rural Health Association. 

Q: RWHC has been around since 1979, making it certainly one of the oldest NCHN network members. Can you talk a little about its beginning and its growth into an organization that provides many valuable services to rural Wisconsiners/ites? Throughout the process, how has the vision evolved?

DJ: The co-op started as a shared service organization in July of 1979, with six members.  Shared staffing services were at the top of the “to do” list, and that lead to other discoveries on how the members could “share” resources to improve services locally, while maximizing the resources they had available at the time.  Legislative issues and potential regulatory changes in Madison and Washington  D.C. quickly added the advocacy component of the work we do, and things grew from there.  I’m sure the vision has evolved over the years, as external and internal factors have no doubt influenced the direction we get from our members, but there has always been a commitment to the common cause “together, we are better”.  That commitment and belief system is still very much in place today, and is really the glue that helps hold all of the moving pieces together. 

Q: As a network that has maintained and successfully grown and adapted to the changing legislative environment, what lessons can you share with other networks?

DJ: This is probably a question best suited for Tim (our Executive Director, and first employee of RWHC, Tim Size), but continuing to find ways to work in collaboration with others, whether they are RWHC members, strategic partners, or some other group or person that has a vested interest in rural healthcare, is paramount to the success of any network.  Tim told me shortly after I started here to “go where the energy exists” around a certain topic.  That could be early adopters of a new service line, or partners for a grant project, but realize that the energy will shift from time to time, and that is okay.  Identifying who has that certain spark or fire regarding a specific topic or issue, gathering those groups together, and assisting them along the way has been a successful approach for us.  Given the current challenges facing rural health care as we move through the process of “reform”, having your members engaged is more important than ever. 

Q: RWHC offers quite a few services and they range from HIT and technical consulting to education and include services that can benefit other health networks. Can you talk a little more about which services are available to help other network leaders?

DJ: Much of what happens at RWHC is the result of collaboration, so we are always willing to assist other like-minded entities (networks, co-ops, etc) by sharing information or lessons learned whenever we can.   Sharing, building relationships, working together with others from around the Country benefits all of us in the long run….not to mention the people we work for and their patients, as well.  Over the years, we have developed services that are geared towards the smaller, rural hospital.  Educational offerings, credentialing services, quality indicators reporting, and patient satisfaction surveys are our most commonly used services, and they are all easily adaptable to work with and for other networks.  Some of them are potential “turn-key” offerings, while others are housed here at RWHC, but can be delivered through partnerships with other networks. 

Q: RWHC is a strong advocate for rural health. What are RWHC’s biggest initiatives at the moment and what kind of barriers are you most focused on?

DJ: Without a doubt, working to make sure that rural Americans have access to high quality health care.  RWHC is committed to helping policymakers understand that what may be a right fit for urban, could have significant detrimental impact to rural providers…..and ultimately jeopardize access to care for millions of Americans. 

Q: You are just entering your second year on the NCHN Board of Directors and are involved in other ways, such as serving on the Program Development Committee and completing the second year of NCHN’s Leadership Learning Community. From your perspective, what are NCHN’s most valuable resources and what direction would you like to see the association move toward in the future? What can NCHN provide more or less of?

DJ: NCHN provides something to networks and network leaders that nothing else can; a place to share, collaborate, and network with others who are in the same boat, facing the same challenges, and looking for the same solutions to provide to their constituencies.  That “energy” if you will, is driving the work of NCHN to create services that will benefit network leaders as they continue along their respective paths.  Education, coaching, group purchasing, advocacy, collaborative opportunities; all of these exist to help networks grow and meet the needs of their members.  It is really a quite exciting time, and I’m looking forward to what the future holds for this organization.

Q: As you look toward the future, what do you think is the biggest challenge facing health networks?

DJ: I think the greatest challenge that is facing health networks is the same as it has always been: remaining relevant.  It is a tall order to fill, but each network has the opportunity to provide something to their membership that is not readily available anywhere else.  That something, that niche, will grow and change and evolve over time, and the network must be able to identify how it will meet the needs of the members in the future.  What value do you create for your membership, and how can you consistently deliver on that premise?  By understanding the unique needs of your members, collaborating whenever possible, hard work…and no doubt a little luck every now and then, the concept of the health network will be alive and well through this process of reform, and for many years to come.